VHA Primary Care Providers’ Perspectives on Screening Female Veterans for Intimate Partner Violence: A Preliminary Assessment

Female Veterans experience intimate partner violence (IPV) at alarming rates. The Veterans Health Administration (VHA) requires foundational research to guide the development of policy and programs to detect IPV among women Veterans and provide interventions. This pilot study reports findings from in-depth qualitative interviews conducted with 12 VHA primary care providers treating female Veterans in the New England region. Although most providers indicated that they were not currently routinely screening for IPV, they expressed positive attitudes and beliefs about screening in VHA primary care settings. Themes also included the importance of a comprehensive health care response to IPV, such as interdisciplinary coordination of care and team-based approaches to detection and intervention. Barriers to routine screening were identified, as well as recommendations for training programs and clinical tools to inform the successful implementation of a standardized IPV screening and response program in VHA. Although preliminary, these findings represent an initial step in an essential line of research.     

An exploratory study of women prisoners’ attitudes towards their self-harm and the use of medical skin camouflage

Self-harm is a growing problem in UK prisons with women self-harming more than men. Self-harm can leave permanent scarring. Research on scarring suggests that living with scars can lead to psychological difficulties; however, there is little research on the specific effects of self-harm scars. Medical skin camouflage (MSC) can be used to cover numerous skin conditions. The use of MSC for women in prison with self-harm scars has not been examined previously. A focus group involving 10 women prisoners aimed to (1) explore feelings about self-harm scars, (2) examine effects that scars have on life in prison and (3) examine thoughts on using MSC in prison. This group formed part of a larger project designed to test the feasibility and acceptability of MSC for women who self-harm in prison. A topic guide was created with two service user researchers with experience of self-harm in prison. The results have been divided into three themes: (1) feelings about self-harm scars, (2) covering self-harm scars and (3) attitudes towards MSC. Our findings indicate that women in prison tend to feel embarrassed and self-conscious about their scars, and the presence of scars affects their relationships within prison. The women were enthusiastic about MSC, suggesting that it has the potential to affect women’s well-being and ability to engage with others.     

The Price of Civil Rights: Black Lives,White Funding,and Movement Capture

What influence do funders have on the development of civil rights legal mobilization? Fundraising is critical to the creation, operation, and survival of rights organizations. Yet, despite the importance of funding, there is little systematic attention in the law and social movements and cause lawyering literatures on the relationship between funders and grantees. This article recovers a forgotten history of the National Association for the Advancement of Colored People's (NAACP) campaign to protect black lives from lynchings and mob violence in the early twentieth century. I argue that funders engaged in a process of movement capture whereby they used their financial leverage to redirect the NAACP's agenda away from the issue of racial violence to a focus on education at a critical juncture in the civil rights movement. The findings in this article suggest that activists tread carefully as the interaction between funders and social movement organizations often creates gaps between what activists want and what funders think movements should do.     

Criminal Records and Employment: A Survey of Experiences and Attitudes in the United States

Ban-the-Box (BTB) legislation, which bans employers from asking about criminal history records on the initial job application, is arguably the most prominent policy arising from the prisoner reentry movement. BTB policies assume: 1) most employers ask about criminal records, and 2) inquiries occur at the application stage. However, we lack reliable information about the validity of these assumptions or about public attitudes towards criminal background checks, which limits our understanding of the potential scope of this innovative policy. Using survey data from a national probability sample, we estimate that in the past year, over 31 million U.S. adults were asked about a criminal record on a job application. According to our survey, virtually all of the criminal record inquiries occurred at the application stage, highlighting the potential of BTB. However, we also found that the public is sharply divided on whether to prevent employers from asking on applications, as per BTB.     

The nearest relative in the Mental Health Act 2007: still an illusionary and inconsistent safeguard?

Abstract

The role of nearest relative (NR) is intended as a safeguard in the Mental Health Act 1983 (as amended in 2007) to curb the excesses of professional discretion and protect patients from unwarranted compulsory hospitalisation. It is unique to the mental health compulsory detention process in England and Wales. There are, however, evident tensions in the role and a lack of clarity surrounding the precise functions of the NR. There is also some uncertainty and confusion among practitioners about the scope of the NR involvement, and government plans announced recently to review mental health legislation will include a focus on the role of family and carers in the care of detained patients. Despite long-standing concerns about the role, there is remarkably little published research available to date on its use and effectiveness, in so far as evaluating the extent to which it provides an adequate safeguard for patients, as intended by the legislation. This article will briefly explore the background to the role, highlight some of the difficulties and tensions within it and conclude with some observations about where further research and reform may be needed to provide greater protection and clarity for patients, relatives and health and social care practitioners.     

Economic Burden of Child Exposure to Intimate Partner Violence in the United States

Because the effects of children’s exposure to intimate partner violence (IPV) carry long lasting consequences for the affected children, IPV exposure may impose a significant economic burden to localities, states, and society at large, made explicit over the victim’s lifetime and over a wide range of behaviors and outcomes, including use of social services, health and healthcare utilization, educational outcomes, workforce productivity, and criminal behavior. While much research has been conducted on the effect of IPV exposure on multiple short- and long-term outcomes, no research to date has examined the economic burden associated with IPV exposure. Using an incidence-based approach, we estimated the aggregate discounted costs associated with healthcare spending, criminal behavior, and labor market productivity accrued by a 20-year-old victim in 2016 projected to the age of 65, applying a 3% discount rate. The average lifetime costs derived from childhood IPV exposure are estimated to be over $50,000 per victim (2016 U.S. dollars) due to increased healthcare costs ($11,000), increased crime costs ($14,000), and productivity losses ($26,000). Over an annual birth cohort of young adults, these costs amount to over $55 billion nationwide. IPV exposure imposes a substantial economic burden to society at large in the form of increased healthcare costs, increased crime costs, and reduced productivity. This study offers an explicit quantification of substantial lifetime costs, which should encourage policy makers to redouble efforts to reduce the incidence of IPV and successfully ameliorate its effects on IPV-exposed children.     

Shoot/No-Shoot Decisions in the Context of IED-Detection Training and Eyewitness Memory for Persons

Cognitive approaches to training for the detection of improvised explosive devices (IED’s) are of increasing importance. However, there is a question as to the degree to which such training might interfere with other important law enforcement (LE) functions in the field, and the degree to which such training might enhance other important cognitive/perceptual functions. A promising cognitive approach to IED training, the SMOKE system, was provided to respondents, who then responded to shoot/no-shoot decisions, important LE situations of increasing relevance. It was shown that SMOKE training did not interfere with shoot/no-shoot decisions. However, those with SMOKE training performed better than control respondents on eyewitness memory for the perpetrator of a given crime in field-valid scenes. This indicates that cognitively based training may enhance vigilance and resultant memory in field situations.     

Intergenerational Transmission of Violence: the Influence of Self-Appraisals,Mental Disorders and Substance Abuse

Although research has demonstrated connections between experiencing abuse as a child and being in a violent relationship as an adult, the specific mechanisms through which this transmission occurs are unclear. The purpose of this study was to identify the relationship between certain personal factors (self-appraisals and mental/substance use disorders) and experiencing violence as an adult. Data from the National Comorbidity Survey (NCS) 1990–1992 were utilized. Respondents who reported experiencing childhood abuse or victimization and were in a current intimate partnership (N = 590) were selected for analysis. Multivariate logistic regression indicated that low self-esteem, past year PTSD, and past year alcohol dependence were significantly associated with intimate partner violence after controlling for other self-appraisals and mental disorders.